Journal of Kerman University of Medical Sciences
Year:2008 | Volume:15 | Issue:1|Papers Count:15

Introduction: Post transplant erythrocytosis (PTE), defined as a hematocrit level of above 51 percent, is a multifactorial condition common in renal transplant recipients. Traditional therapies include repeated phlebotomies, bilateral native nephrectomies, and anticoagulant therapy. The aim of this study was to evaluate the efficacy of ACE inhibitor on PTE.Methods: This analytic outcome study was done on all transplant patients referred to Shaid Rahnemoon hospital (Yazd, Iran). Hematocrit (HCn and hemoglobin were assessed in two blood samples taking from the patients. Patients with HCT >51 were selected and studied for other causes of polycythemia. Not fmding other causes, the patients were diagnosed as PTE and received Enalapril tab (5 mg /daily). Blood pressure, HCT and Hb of these patients were recorded during next 3 months (30, 60, 90th post-treatment days).Results: Among 126 referred patients, 47 patients had erythrocytosis [37 males (86%) and 6 females (14%)] that shows a higher prevalence in comparison with other studies. All patients responded to Enalapril treatment Before treatment, mean hemoglobin and hematocrit were 18.35±0.59 gr/l and 55.96±1.90mm respectively, while after 3 months treatment with Enalapril, hemoglobin and hematocrit decreased to 16.7±0.5 mgl/and 48.73±1.42mm respectively.Conclusion: Enalapril is an effective treatment of PTE and can prevent the need for phlebotomy or nephrectomy in these patients.

Introduction: P.aeruginosa is one of the causes of nosocomial infections with an unusual resistance to antibiotics. The source of resistance in this bacterium may be chromosomal or plasmid. The aim of the present study was to investigate the antibacterial susceptibility patterns with the presence of plasmids in P. aeruginosa isolates.Method: In this study, 140 P.aeruginosa isolates were collected from hospitals in Urmia/Iran, The susceptibility patterns were determined against antibiotics. Plasmids were extracted by alkaline lysis method, electrophoresed and investigated by a DV transilluminator. Single digestion of plasmids with EcoR1 arid HincII was performed and the restriction patterns were compared using a ladder.Results: The rates of resistances to antibiotics were as follows: gentamicin 49.3%, cephalothin 99.3%, ticarcillin 100%, ceftizoxime 79.3%, co-trimoxazole 97.7%, amikacin 35%, carbenicillin 67.1%, ceftriaxone 65.7%, ciprofloxacin 58.6%, piperacillin 52.8%, imipenem 1.4%, kanamycin 65.7%, of loxacin 72.1% and ampicillin 100%. In Whole, 65.7% of isolates harbored plasmids. Restriction enzyme analysis of plasmids showed unique pattern for all of plasmid positive isolates. All the plasmid positive isolates were resistant to ceftriaxone and kanamycin. The plasmid source of resistance to ceftriaxone was proved by plasmid elimination and transformation in E.coliDH5a and the plasmid source of resistance to kanamycin was proved by plasmid elimination. Also there was a significant correlation between the presence of plasmid in isolates and resistance to some of antibiotics.Conclusion: There was a high frequency of plasmids in P.aeruginosa isolates, indicating that plasmids have an important role in transferring of resistance genes in this bacterium.

Introduction: Visceral pain is one of the most common forms of pain which requires new therapeutical drugs. The aim of this study is to investigate the inhibitory effect of gabapentin on induced abdominal contractions and to examine the effect of its co- administration with morphine Method: In this study, 96 mice received acetic-acid intraperitoneally after administration of saline, gabapentin (1, 5, 10, 50 and 100 mg/kg), morphine (0.25, 0.5, 1, 3 and 5 m/g kg) or a combination of subanalgesic dose of morphine with subanalgesic and the lowest effective dose of gabapentin. In one group naloxone (5mg/kg/i.p) was injected 20 minutes prior to the injection of acetic acid. Then the number of writhes was counted for 45 minutes.Results: Both gabapentin and morphine reduced writhing in a dose-dependent manner. The number of writhes decreased significantly by gabapentin (50 and 100/ mg/ kg) and morphine (0.5, 1, 3, 5 mg/kg) comparing to the control group (P<0.001). Also, the sub-analgesic dose of morphine (0.25mg/kg) with subanalgesic and low effective dose of gabapentin (50mg/kg & 10mg/kg, respectively) significantly decreased the number of writhes (P<0.005). The combination of low effective dose of gabapentin (50mg/ kg) and subanalgesic dose of morphine decreased the number of writhings by 94% as compared to the controls (p<0.005). The antinociceptive effect of combinational administration was not reversed by naloxone (opioid antagonist).Conclusion: These data demonstrated the comparable efficacy of gabapentin (50 and 100/ mg/ kg; i.p.) with 0.5mg/kg morphine in visceral pains. Also the combination of subanalgesic doses of gabapentin and morphine, which were ineffective alone, produced significant analgesic effect in writhing model of pain. Therefore, combination of low doses of morphine and gabapentin, due to lower rate of side effects, may be clinically considered as a safer treatment in the management of visceral pains.

Introduction: Oxidative stress due to overproduction of reactive oxygen species and impairment in antioxidant defense mechanisms have been suggested as possible factors contributing to the pathogenesis of atherosclerosis in patients with end- stage renal disease. The aim of this study was to evaluate antioxidant markers of oxidative stress including glutathione and glutathione related enzymes [i.e. glutathione peroxidase (GPx) and glutathione reductase (GR)] as well as total antioxidant capacity in peritoneal dialysis (PD) patients.Methods: Twelve PD patients and 17 healthy controls (age range: 25-60 and 22-53 years respectively) were selected. Erythrocyte glutathione levels and plasma activities of GPx, GR and total antioxidant capacity were determined spectrophtometrically.Results: Glutathione levels and GPx activity were significantly lower in the patients group than in controls (1.17± 0.28 vs. 1.42±0.25 mmol/ml and 57.1±21.8 vs. 142.5±31.7 U/L; p<0.05, respectively). Higher levels of GR activity and total antioxidant capacity were noted in patient group (57.5±16.4 U/L and 0.60±0.09 mmol/ml; respectively) in comparison to control group (32±9.4 U/L and 0.47±0.11 mmo/ml; p<0.05, respectively). Conclusion: Decreased glutathione levels and alteration in the activities of its related enzymes imply increased oxidative stress and disturbances of antioxidant defense systems in peritoneal dialysis patients. This condition may contribute to the development of accelerated cardiovascular disease and its morbidity and mortality in these patients.

Introduction: Despite the countless benefits of breast milk, each year many infants are admitted to NICD's with clinical symptoms and laboratory indicators of dehydration and renal failure due to the lack of a national program to monitor post discharge breastfeeding over the first few days of life. In addition to identifying the role of inadequate breast milk intake as a cause of renal failure, the purpose of this study was to assess causes, clinical presentations and laboratory tests in acute renal failure and to identify the most available and practical laboratory test to differentiate prerenal from renal azotemia.Methods: A cross-sectional prospective study was performed between April 2005 and May 2006 (14 months) at Afzalipour Medical Centre in Kerman, Iran. All neonates with high serum blood urea and creatinine were included in the study. The percentage of weight loss, breast feeding, mode of delivery, and clinical presentations were recorded. Laboratory tests such as blood urea, serum and urine sodium and creatinine and, urine specific gravity were done. Data were analyzed by SPSS software, chi- square test and t- test.Results: Among 36 neonates, who were eligible for the study, 29 cases (80%) had dehydration (group I) and 7 cases (20%) had intrinsic renal failure (group II). In the first group, mean weight loss was 14% and mean age at admission was 10 days. Reasons for admission were poor feeding (69%), lethargy (58%), fever (30%), jaundice, vomiting and seizure. The mode of delivery in 69% of cases was vaginal route and 82% of cases were breast-fed. Decreased urine frequency in the previous day «6 times per day) was considered more significant than decreased stool frequency « 3 times per day). Serum sodium and urine specific gravity in group I was significantly higher than group 11(P< 0.05).Conclusion: This study confirms that an excessive weight loss over the first few days of life and decreased urine and stool frequency might be considered as a warning for failure of receiving enough milk. Serum sodium and urine specific gravity are the most sensitive laboratory parameters, for the assessment of dehydration.

Introduction: Brain edema is one of the most important causes of death within the first few days following head trauma. In this study we investigated the role of gender as well as the effects of progesterone and allopregnanolone one hour after diffuse traumatic brain injury on edema formation in rats.Method: This interventional-experimental study was performed on 12 groups of female and male rats. They were divided into 12 groups as follows: 1 and 2: intact female and male rats, 3 and 4: trauma male and female rats, 5: vehicle of progesterone (benzyl alcohol with sesame oil) , 6: sham (ovariectomized female rats: ovx), 7: sham (no ovx), 8: sham(male), 9 and 10: low dose (4mg/kg) and high dose (8mg/kg) of progesterone, 11: allopregnanolone and 12: vehicle of allopregnanolone (water). Hormones were injected i. p one hour after diffuse traumatic brain injury through Marmarou model.Results: The results showed a significant increase of 5. 32 times in Evans blue and 2. 42% in water content in trauma male group comparing to control groups, while in female rats the difference was significant just for Evans blue (4.68 times). Evans blue and water content were also significantly greater in traumatic males than female rats (1.57 times and 2.04% respectively). After injection of low and high doses of progesterone, there was a significant decrease in water content (2.21% and 2.30%) and Evans blue content (2.55 and 2.98 times). Allopregnanolone significantly decreased these parameters (2.36% and 1.82 times respectively). Moreover, the injection of progesterone in both low and high doses increased the serum progesterone of female ovarectomized rats as compared to vehicle group. Conclusion: Based on these results, it can be concluded that the rate of edema formation in traumatic male rats is higher compared to traumatic female rats. Moreover, both progesterone and allopregnanolone decrease edema formation in ovariectomized female rats.

Introduction: Methamphetamine (MAMP) is a central nervous system stimulant, but it is increasingly abused as a psychedelic tablet by teenagers and young adults. In this experimental study, we evaluate the effects of MAMP on sperm parameters of mature rat.Methods: MAMP or saline were injected in three experiments as follow: In the first experiment, twenty-four rats were injected one time with 10mg/kg MAMP, and sperms were sampled from tail of epididymis 6, 12, 24, 48, 72, and 168 h after injection (n=4, at each time). Six rats injected with saline served as controls. In the second experiment, four groups of rats each consisting of four rats were administered MAMP (5, 10 and 15mg/kg) or saline, respectively, and examined 24h later. In the third experiment, 16 rats were evenly divided into four groups (1, 5, and 10 mg/kg MAMP and control) and were injected MAMP or saline once daily for 14 consecutive days (spermatogenesis period) and sperms were sampled 24 h after the last injection.The motility, concentration and morphology of the sampled sperms were evaluated. We also measured the body and testis weights and used the testis/body weight ratio as an index at the end of each experiment.Results: At 24 and 48 h after injection with a single dose of 10 mg/kg MAMP, the number of sperms decreased significantly in comparison with controls (p£0.001 and P£0.05 respectively). In the second experiment, the number of sperms for three doses of MAMP significantly decreased in the two upper doses (P<0.001) and in the lower dose (P£0.05).The results of the third experiment were similar but the decrease of sperms number was more than that in the second experiment. MAMP did not change the testis/body weight ratio in the first and second experiments, but it significantly decreased this index in rats of the third experiment which received 10 and 5 mg/kg MAMP daily. We did not observe differences between experimental and control groups in motility and morphology of sperms.Conclusion: Our results indicate that the repeated administration and/or higher doses of MAMP reduce the number of mature sperms in the tail of epididymis and have adverse effects on the reproduction and fertility of MAMP users.

Introduction: Median rhomboid glossitis (MRG) or central papillary atrophy is an uncommon benign abnormality of the tongue, most frequently affecting men and it is believed that candidacies is the major etiologic factor for this abnormality. The purpose of this study was to investigate the prevalence of MRG and its characteristics in 837 students in Kerman University ofrv1edical Sciences.Methods: In this research, 837 Medical Sciences students in 2006 were selected by census sampling and enrolled into the study. Oral examinations were performed in classes, wards and dormitories. All characteristics of subjects were recorded in a researcher-mode form and in those who had MRG based on clinical diagnosis, a sample was taken by swab and sent to the laboratory for candidiasis infection (hypha).  Data were analyzed by SPSS 13.5 and using t-test and c2 test.Results: The results showed that the prevalence of MRG is about 1.5% (13 cases). There was a relationship between MRG and sex, but there was no relation between MRG and age. In 11 cases (84.6%) the smears were positive for candidiasis infection (hypha).Conclusion: Based on previous published studies in the past and the present study, candidiasis infection (hypha) is a main factor for MRG. Therefore, in the cases of having median rhomboid glossitis, all causing factors for candidiasis should be examined and removed.

Introduction: In the heart cells, ultrarapid delayed rectifier potassium current (IKur) is one of the important currents in action potential repolarization phase. Ultrarapid delayed rectifier potassium current is specifically blocked by low concentration of 4-Amino Pyrimidine(4-AP). The aim of this study was to determine the effect of low concentration of 4-Amino Pyrimidine blocker on pacemaker activity of sinoatrial node (SAN) and atrioventricular node (AVN) of mouse heart.Method: SAN and AVN were separated and the pacemaker activity of distinct intact SAN and AVN was recorded before and during 50uM4-AP by two separate metal microelectrodes that were in.contact with the endothelail surface of the nodes. Then the action potential cycle length (CL) was measured.Results: 50m M4-Amino Pyrimidine increased the action potential cycle length of SAN and AVN preparations respectively by 20.2±3.3% and 18±3% these increases on the action potential cycle length were significant in both nodes.Conclusion: According to the results, IKur is present in both SAN and AVN nodes and the effect of 50m M4-AP on action potential cycle length (CL) of the two nodes is the same.

Capgras syndrome is one of the misidentification syndromes. In this phenomenon the patient has a delusional belief that familiar persons have been replaced by imposters. We report a middle aged schizophrenic female who believed that the lower half of her body has been replaced by that of another person, known as prostitute by the patient. She also reported hallucination of sexual intercourse. Rare variants of Capgras syndromes have been reported so far, but there is no report of delusion of half of body replacement. The mentioned case can be considered as incomplete Capgras syndrome that is another variant of this syndrome.

Elbow dislocation, though not a rare injury has been only occasionally reported to occur bilaterally. An extremely rare case of upper extremity trauma is reported in which bilateral simultaneous posterior elbow dislocation associated with bilateral radial neck fractures had occurred. To the best of our knowledge, this hasn't been reported previously. Although radial head excision has been reported to be associated with good outcome in cases of elbow dislocations with fracture of radial neck, the trend has been toward preservation of the head and it seems that this is a more logical approach.

Molecular epidemiology is relatively a new scientific field that explores the epidemiological aspects of diseases using molecular techniques. Genetic epidemiology is a branch of molecular epidemiology that explores the expression of genes and the interactions between genes and environment. Moreover, molecular epidemiology is one of the best methods to address some specific issues such as:1. Exploring how diseases such as HIV/AIDS had expanded among countries and in the world 2. Exploring the distribution of diseases in populations and tracking their transmission chains 3. Exploring the virulence of pathogens using molecular markers and linking their characteristics to the epidemiological indicators such as incidence and prevalence in this paper written for general practitioners and medical experts, the applications of molecular epidemiology in public health and medicine by unfolding simple and practical examples have been discussed.